The goals of the Administrative and Patient Access Core of the NYCC-SPOTRIAS are to support the overall organization of our acute stroke research program and to provide efficient, timely, and state of the art access and evaluation of patients who present with acute stroke through a well-organized, coordinated, protocol-driven acute stroke team. Our center serves a disadvantaged population who have increased stroke risk, greater health access limitations, and present significant acute stroke treatment challenges. Meeting these goals will involve collaboration among the departments of emergency medicine, neurology, critical care, radiology, and neurosurgery, as well as the active involvement of nursing. Our center has had a stroke team in place since its founding in 1983 and a stat stroke page system active 24 hours a day, 7 days a week since 1994 to facilitate the rapid diagnosis and treatment of acute stroke patients. Evidence of the strength of our organization can be found in the success of our participation in multiple stroke clinical trials and our role as a coordinating center in multicenter stroke studies. The aims of the Patient Access core are to treat at least 12 acute stroke patients with intravenous rt-PA within 2 hours annually and identify and recruit eligible acute stroke patients for our three SPOTRIAS projects. Through this core we will build on our existing infrastructure by expanding existing acute stroke initiatives and developing new protocols including the staffing of an acute stroke care coordinator team; monitoring continuous quality improvement performance targets through the stroke surveillance database; evaluate an EMS activated acute stroke page system; standardizing acute stroke protocols across the NY Presbyterian Healthcare System; facilitating transfer of stroke patients to our comprehensive stroke center; and expansion of acute stroke educational programs for healthcare and pre-hospital workers. These enhanced programs will greatly increase our ability to recruit and treat acute stroke patients.